Quiz Question

In Sullivan 2025 et al., on TTT stabilization methods, what theoretical advantage does the spacer pin technique offer?

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Correct. Avoiding tuberosity pins may reduce risk of soft tissue irritation or fracture.
Incorrect. The correct answer is Avoids placing pins through tuberosity.
Avoiding tuberosity pins may reduce risk of soft tissue irritation or fracture.

šŸ” Key Findings

  • Spacer pin fixation showed no difference in failure force or stiffness compared to tension band wire (TBW) or 2-pin techniques.
  • All constructs failed under loads >1000 N, exceeding estimated peak quadriceps force in dogs during walking (~240 N).
  • Patellar ligament failure was the most common mode of failure across all groups (5–8 samples per group).
  • Distal tibial crest fractures were seen only in 2-pin and spacer pin groups, not in TBW group, suggesting TBW may protect against crest failure.
  • No failures occurred at pin tracts, possibly due to pin placement within patellar ligament footprint.
  • Spacer pin technique avoids placing pins through the tuberosity, potentially reducing risks of soft tissue complications like tendinopathy or irritation.
  • Use of partial osteotomy with robust distal crest may substitute for TBW without compromising initial mechanical strength.
  • Further in vivo or cyclic loading studies are required, as this cadaveric study tested only acute tensile failure.

Sullivan

Veterinary and Comparative Orthopaedics and Traumatology

3

2025

Biomechanical Comparison of Spacer Pin Fixation to Two Established Methods of Tibial Tuberosity Transposition Stabilization in Dogs

2025-3-VCOT-sullivan-4

Article Title: Biomechanical Comparison of Spacer Pin Fixation to Two Established Methods of Tibial Tuberosity Transposition Stabilization in Dogs

Journal: Veterinary and Comparative Orthopaedics and Traumatology

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In Cheon 2025 et al., on guide accuracy in DFO, how did correction accuracy compare between uniplanar and biplanar deformities?

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Correct. The study found no significant difference between uniplanar and biplanar correction outcomes.
Incorrect. The correct answer is No significant difference found.
The study found no significant difference between uniplanar and biplanar correction outcomes.

šŸ” Key Findings

  • Both patient-specific and universal guides yielded correction errors <2°, with no statistically significant difference in accuracy.
  • Universal guide corrected aLDFA up to 24° and AA up to 20°, addressing multiplanar deformities effectively.
  • Patient-specific guides allowed for preoperative simulation, providing more stable pin placement and potentially aiding less-experienced surgeons.
  • Universal guide eliminated the need for CT-based customization, reducing time and cost.
  • Cadaver and bone model trials showed consistent accuracy, validating both methods in vitro and ex vivo.
  • No significant differences in outcome when correcting uniplanar (aLDFA) vs biplanar (aLDFA + AA) deformities.
  • Universal guide's fixed size presented limitations in small dogs, potentially requiring multiple size options.
  • Universal guide showed potential for standard use, offering repeatable outcomes with minimal prep despite needing precise intraoperative placement.

Cheon

Veterinary and Comparative Orthopaedics and Traumatology

3

2025

Comparing the Accuracy of Patient-Specific Guide and Universal Guide for Distal Femoral Osteotomy in Dogs

2025-3-VCOT-cheon-5

Article Title: Comparing the Accuracy of Patient-Specific Guide and Universal Guide for Distal Femoral Osteotomy in Dogs

Journal: Veterinary and Comparative Orthopaedics and Traumatology

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In Scott 2025 et al., on acetabular cup revision, what revision approach was used in all cases?

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Correct. In all 9 dogs, cups were revised to larger-diameter BFX cups for new osseointegration.
Incorrect. The correct answer is Cup replacement using a larger press-fit cup.
In all 9 dogs, cups were revised to larger-diameter BFX cups for new osseointegration.

šŸ” Key Findings

Population: 9 dogs underwent revision of osteointegrated acetabular cups after total hip arthroplasty (THA)

Revision Indications:

  • 7 luxations (5 ventral, 2 craniodorsal)
  • 1 femoral stem fracture
  • 1 aseptic stem loosening

Implants:

  • 8 BFX cups, 1 Helica; all revised to BFX
  • 7/9 required a larger cup than original

Cup removal: Required sectioning with a high-speed burr and modular osteotome; removal fragments extracted

Complications:

  • 1 recurrent luxation
  • 1 low-grade infection with possible metallic debris-associated osteolysis
  • 2 femoral fissures managed intraoperatively

Outcomes:

  • Good to excellent function in 6/6 dogs available at median 621 days
  • Minimal complications with success in re-osteointegration of new cup

Clinical takeaway: Revision of stable, ingrown cups is feasible and offers an alternative to pelvic osteotomies; typically requires upsizing

Scott

Veterinary Surgery

3

2025

Revision of osteointegrated acetabular cup prostheses in nine dogs

2025-3-VS-scott-3

Article Title: Revision of osteointegrated acetabular cup prostheses in nine dogs

Journal: Veterinary Surgery

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In Story 2024 et al., on surgical correction of excessive tibial plateau angle (eTPA), what was a key rationale for using neutral wedge osteotomies like PTNWO and mCCWO in dogs with eTPA?

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Correct. Both techniques preserved tibial length better than TPLO-based techniques, making them preferable when length preservation is critical.
Incorrect. The correct answer is They minimize tibial length change.
Both techniques preserved tibial length better than TPLO-based techniques, making them preferable when length preservation is critical.

šŸ” Key Findings

  • All four techniques achieved TPA <14°, meeting the threshold for acceptable surgical correction in eTPA cases.
  • Group A (CBLO + CCWO) and Group D (PTNWO) showed highest accuracy in achieving target TPA values.
  • Group B (TPLO + CCWO) resulted in significant tibial shortening compared to other techniques.
  • Group A caused the greatest cranial mechanical axis shift, while Group B caused the least.
  • Group C (mCCWO) resulted in consistent under-correction of TPA, despite aiming for 0°.
  • Modified or neutral wedge osteotomies (Groups C and D) had minimal effect on tibial length, making them suitable when preservation is important.
  • All techniques involved mechanical axis shifts, highlighting the importance of preoperative planning to minimize morphologic disruption.
  • Supplemental fixation was standard for all procedures to reduce risks such as tibial tuberosity fracture and plateau leveling loss.

Story

Veterinary Surgery

8

2024

Morphologic impact of four surgical techniques to correct excessive tibial plateau angle in dogs: A theoretical radiographic analysis

2024-8-VS-story-5

Article Title: Morphologic impact of four surgical techniques to correct excessive tibial plateau angle in dogs: A theoretical radiographic analysis

Journal: Veterinary Surgery

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In Alvarez 2024 et al., which quadrant had significantly reduced compression when only Kern forceps were used?

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Correct. Kern forceps alone produced compression mostly in the craniomedial quadrant, reducing caudal compression:contentReference[oaicite:1]{index=1}
Incorrect. The correct answer is CaudoĀ­lateral.
Kern forceps alone produced compression mostly in the craniomedial quadrant, reducing caudal compression:contentReference[oaicite:1]{index=1}

šŸ” Key Findings Summary

  • F + P (forceps + plate compression) achieved the most uniform, high-pressure distribution across all quadrants.
  • Kern forceps alone concentrated force in craniomedial quadrant, reducing caudal compression.
  • Combining Kern + F improved craniolateral compression but did not restore caudal compression.
  • Plate compression alone yielded caudal bias, not uniform pressure.
  • Significant inter-method variation in quadrant-specific compression confirmed via ANOVA (p < 0.001 for all quadrants).

Alvarez

Veterinary and Comparative Orthopedics and Traumatology

2

2024

In Vitro Assessment of Compression Patterns Using Different Methods to Achieve Interfragmentary Compression during Tibial Plateau Levelling Osteotomy

2024-2-VCOT-alvarez-2

Article Title: In Vitro Assessment of Compression Patterns Using Different Methods to Achieve Interfragmentary Compression during Tibial Plateau Levelling Osteotomy

Journal: Veterinary and Comparative Orthopedics and Traumatology

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In Espinel RupƩrez 2023 et al., on hip toggle stabilization, what was a major cause of technique deviation?

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Correct. This was a common deviation; though implant positions were ideal, 8 major deviations were noted—all in the femoral tunnel.
Incorrect. The correct answer is Femoral tunnel exit outside fovea capitis.
This was a common deviation; though implant positions were ideal, 8 major deviations were noted—all in the femoral tunnel.

šŸ” Key Findings

  • Arthroscopic-assisted hip toggle stabilization (AA-HTS) was successfully completed in all 14 feline cadaver joints.
  • Femoral and acetabular tunnel creation was feasible in all cases, though femoral tunnel placement had a higher rate of deviations.
  • Intraoperative complications occurred in 5/14 joints, mostly related to femoral tunnel creation and toggle lodging.
  • Minor articular cartilage injury (<10% total cartilage area) occurred in 10/14 joints, but no injury to neurovascular or intrapelvic structures.
  • Thirteen surgical technique deviations (8 major, 5 minor) were identified in 7 joints, all involving the femoral tunnel.
  • Toggle passage through the femoral tunnel was the most challenging step, being mildly difficult in 6 joints.
  • Postoperative CT and gross dissection confirmed all toggles and buttons were in correct position, without damage to major surrounding structures.
  • No deviations, complications, or cartilage injuries occurred in the last 4 joints, suggesting a learning curve effect.

Espinel RupƩrez

Veterinary Surgery

6

2023

Arthroscopic-assisted hip toggle stabilization in cats: An ex vivo feasibility study

2023-6-VS-espinel-5-cdb86

Article Title: Arthroscopic-assisted hip toggle stabilization in cats: An ex vivo feasibility study

Journal: Veterinary Surgery

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In De Moya 2023 et al., on femoral physeal/neck fracture repair, what was the most commonly reported complication of FGPP in this case series?

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Correct. Implant migration was reported in 2 of 5 complication cases, making it the most common.
Incorrect. The correct answer is Implant migration.
Implant migration was reported in 2 of 5 complication cases, making it the most common.

šŸ” Key Findings

  • FGPP (fluoroscopic-guided percutaneous pinning) resulted in successful healing in 10/13 fractures, with good limb function.
  • Complications occurred in 5 of 11 cases, including intra-articular implants, malunion, implant failure/nonunion, and implant migration.
  • Cases with delayed surgery (>15 days) or radiographic remodeling were more likely to experience major complications.
  • Most fractures (10/13) were classified as Salter-Harris type I with mild displacement.
  • Median surgical time was 60 minutes, and no conversions to open surgery were needed.
  • Postoperative femoral neck resorption was minimal, suggesting possible benefits of the minimally invasive approach for preserving vascular supply.
  • One intra-articular pin led to progressive joint disease and required femoral head ostectomy.
  • FGPP appears best suited for acute, minimally displaced fractures in young dogs (<8 months) with planned elective explant to avoid growth disturbance.

De Moya

Veterinary Surgery

6

2023

Closed reduction and fluoroscopic‐guided percutaneous pinning of femoral capital physeal or neck fractures: Thirteen fractures in 11 dogs

2023-6-VS-demoya-3

Article Title: Closed reduction and fluoroscopic‐guided percutaneous pinning of femoral capital physeal or neck fractures: Thirteen fractures in 11 dogs

Journal: Veterinary Surgery

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In Mazdarani 2025 et al., on simulated muscle loading, which model showed the lowest muscle force ratios (quadriceps:gastrocnemius)?

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Correct. Model 2 consistently showed lower ratios compared to others (p = .007).
Incorrect. The correct answer is Model 2 (rigid femoral fixation).
Model 2 consistently showed lower ratios compared to others (p = .007).

šŸ” Key Findings

  • Simulated quadriceps and gastrocnemius forces increased proportionally with axial load in all three femoral fixation models.
  • Model 2 (rigid fixation) resulted in subphysiologic quadriceps forces and abnormally high gastrocnemius forces, reducing model fidelity.
  • Models 1 and 3 (with hip mobility) produced more physiologic quadriceps and force ratios, especially under 30–40% bodyweight loads.
  • Force ratios were significantly lower in rigid fixation (Model 2) compared to hip-mobile models (p = .007), suggesting model design affects simulated muscle coordination.
  • Joint angles (stifle and hock) remained within acceptable limits, though slight flexion occurred with increasing load.
  • Relative foot position differed by ~3.9 mm between models 2 and 3, with model 2 showing a more caudal position.
  • Model 3 preserved benefits of hip mobility while allowing radiographic documentation, making it a preferred setup for future studies.
  • The study suggests that models used in feline stifle stabilization research may underestimate physiologic forces, especially with rigid fixation designs.

Mazdarani

Veterinary Surgery

5

2025

Proximal femoral fixation method and axial load affect simulated muscle forces in an ex vivo feline limb press

2025-5-VS-mazdarani-2

Article Title: Proximal femoral fixation method and axial load affect simulated muscle forces in an ex vivo feline limb press

Journal: Veterinary Surgery

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In Caldeira 2025 et al., on femoral neck fixation, what complication was more likely with the three-screw construct?

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Correct. The three-screw placement had higher risk of cortical bone wall perforation, especially with narrow femoral necks
Incorrect. The correct answer is Increased risk of cortical perforation.
The three-screw placement had higher risk of cortical bone wall perforation, especially with narrow femoral necks

šŸ” Key Findings

Design: In vitro study on cadaveric femurs (n=21) with basilar femoral neck fractures stabilized using 2 vs 3 titanium cannulated screws.

Stiffness: Control > 3-screw > 2-screw (674 > 120 > 90 N/mm).

Yield Load: 3-screw (586 N) > 2-screw (303 N); both < intact femur (2692 N).

Displacement: No difference across groups.

Complication: 3-screw technique more demanding; higher risk of cortical perforation, especially with narrow femoral necks.

Failure Mode: Dislodgement of femoral head + screw shaft bending.

Conclusion: 3 screws = stronger construct than 2 screws. Clinical implications need further study.

Caldeira

Veterinary and Comparative Orthopedics and Traumatology

1

2025

In Vitro Biomechanical Study of Femoral Neck Fracture Fixation with Two or Three Cannulated Screws in Dogs

2025-1-VC-Caldeira-3

Article Title: In Vitro Biomechanical Study of Femoral Neck Fracture Fixation with Two or Three Cannulated Screws in Dogs

Journal: Veterinary and Comparative Orthopedics and Traumatology

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In Mazdarani 2025 et al., on simulated muscle loading, which fixation model produced the most physiologic quadriceps forces?

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Correct. Model 3 preserved near-physiologic quadriceps loads with improved reproducibility over Model 1.
Incorrect. The correct answer is Model 3 (flexion-extension hip mobility).
Model 3 preserved near-physiologic quadriceps loads with improved reproducibility over Model 1.

šŸ” Key Findings

  • Simulated quadriceps and gastrocnemius forces increased proportionally with axial load in all three femoral fixation models.
  • Model 2 (rigid fixation) resulted in subphysiologic quadriceps forces and abnormally high gastrocnemius forces, reducing model fidelity.
  • Models 1 and 3 (with hip mobility) produced more physiologic quadriceps and force ratios, especially under 30–40% bodyweight loads.
  • Force ratios were significantly lower in rigid fixation (Model 2) compared to hip-mobile models (p = .007), suggesting model design affects simulated muscle coordination.
  • Joint angles (stifle and hock) remained within acceptable limits, though slight flexion occurred with increasing load.
  • Relative foot position differed by ~3.9 mm between models 2 and 3, with model 2 showing a more caudal position.
  • Model 3 preserved benefits of hip mobility while allowing radiographic documentation, making it a preferred setup for future studies.
  • The study suggests that models used in feline stifle stabilization research may underestimate physiologic forces, especially with rigid fixation designs.

Mazdarani

Veterinary Surgery

5

2025

Proximal femoral fixation method and axial load affect simulated muscle forces in an ex vivo feline limb press

2025-5-VS-mazdarani-1

Article Title: Proximal femoral fixation method and axial load affect simulated muscle forces in an ex vivo feline limb press

Journal: Veterinary Surgery

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Quiz Results

Topic: Femoral Fixation
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